Individual provider Active NPI

Salam Izdain Gharaybeh, M.D.

  • Pediatric Nephrology Physician
  • Corpus Christi, TX
National Provider Identifier
1063452407
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
M3559 Issued in TX
Practice address
3533 S Alameda St
Corpus Christi, TX 78411-1721
Phone
(361) 694-6852
NPI assigned
Jun 7, 2006
Last updated
Oct 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X M3559 TX Primary

Addresses

Primary practice location

3533 S Alameda St
Corpus Christi, TX 78411-1721

Mailing address

3533 S. Alameda Street
Kidney Center
Corpus Christi, TX 78411-6696
Phone (361) 694-4438

Other practice location 1

7210 McPherson Rd Ste 104
Laredo, TX 78041-6505
Phone (956) 794-8400

Other practice location 2

1120 E Ridge Rd
McAllen, TX 78503-5490
Phone (956) 688-1200

Other practice location 3

1515 Holcombe Blvd
Houston, TX 77030-4000
Phone (713) 792-6161

Other identifiers 1

IdentifierTypeStateIssuer
1809345-03MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060811000262 TX Practitioner - Pediatric MedicinePractitioner - Nephrology 2860495850 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Medical CenterGroup PAC ID 3072403096, shared by 6 NPIs, 16 clinicians
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

1016 N Virginia St
Port Lavaca, TX 77979-3000

6410 Fannin St
Houston, TX 77030-3005

6411 Fannin St
Houston, TX 77030-1501
Phone (713) 704-0093

6431 Fannin St
MSB2.100
Houston, TX 77030-1501
Phone (713) 500-7700

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Aug 1, 2022 Accepting new patients
Physicians Referral Service CurrentSince Sep 21, 2022 Accepting new patients
Ut Physicians CurrentSince Aug 1, 2022 Accepting new patients

Locations

1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446

1515 Holcombe Blvd
#M
Houston, TX 77030
Phone (713) 792-6127

1515 Holcombe Blvd
#R4212
Houston, TX 77030
Phone (713) 794-5446

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

8810 Highway 6
Ste 100
Sienna Plantation, TX 77459
Phone (713) 486-1200

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1063452407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 S. ALAMEDA STREET",
            "address_2": "KIDNEY CENTER",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784116696",
            "telephone_number": "361-694-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 S ALAMEDA ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784111721",
            "telephone_number": "361-694-6852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7210 McPherson Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Laredo",
            "state": "TX",
            "postal_code": "780416505",
            "country_code": "US",
            "telephone_number": "956-794-8400",
            "fax_number": "956-712-3769",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1120 E Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "McAllen",
            "state": "TX",
            "postal_code": "785035490",
            "country_code": "US",
            "telephone_number": "956-688-1200",
            "fax_number": "361-808-2075",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 Holcombe Blvd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770304000",
            "country_code": "US",
            "telephone_number": "713-792-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHARAYBEH",
        "first_name": "SALAM",
        "middle_name": "IZDAIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "TX",
            "license": "M3559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1809345-03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.